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The proportion of heart attack patients who are 40 or younger has steadily increased over the last decade, according to research set to be presented March 17 at the American College of Cardiology’s scientific sessions in New Orleans.

Senior author Ron Blankstein, MD, and colleagues studied 2,097 patients age 50 or younger who were admitted to two large hospitals for myocardial infarction (MI) from 2000 to 2016. One-fifth of those patients were 40 or younger, and the proportion of those very young heart attack sufferers increased by 2 percent annually over the final 10 years of the study, according to an ACC press release.

“It used to be incredibly rare to see anyone under age 40 come in with a heart attack—and some of these people are now in their 20s and early 30s,” Blankstein, a preventive cardiologist at Brigham and Women’s Hospital and associate professor at Harvard Medical School, said in the release. “Based on what we are seeing, it seems that we are moving in the wrong direction.”

Compared to MI patients in their 40s, younger individuals were more likely to have single-vessel disease but were equally likely to experience adverse outcomes, including death, following their heart attacks. They were also nearly twice as likely to report substance abuse, including marijuana and cocaine (17.9 percent vs. 9.3 percent), but had less alcohol use.

Blankstein noted there was a trend toward fewer aspirin or statin prescriptions for patients who were 40 or younger, which may reflect a bias from physicians who are falsely reassured by their age.

“Many people think that a heart attack is destined to happen, but the vast majority could be prevented with earlier detection of the disease and aggressive lifestyle changes and management of other risk factors,” Blankstein said. “My best advice is to avoid tobacco, get regular exercise, eat a heart healthy diet, lose weight if you need to, manage your blood pressure and cholesterol, avoid diabetes if you can, and stay away from cocaine and marijuana because they’re not necessarily good for your heart.”

In a related study, Blankstein and colleagues found 1 in 5 patients who were admitted for a heart attack at age 50 or younger had diabetes. That work will also be presented at the ACC’s scientific sessions, according to the release.